| NPI | 1770179772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071010394) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC0700X Psychologist Clinical (Licence: NY 024063) | |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2025-08-27 |